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THE Wichita, Kans., laborer could not climb stairs or walk more than a few steps without feeling an exasperating pain in his legs. He did not know it but the arteries leading to his legs were clogged with a fatty cholesterol-like substance—what physicians call an atheroma. But that was the least of his troubles. The deposits were also forming in the neck arteries that feed the brain. If nothing were done, Herman Key was headed for a stroke.

Complaining about the pain in his legs, Key, 54, was referred to Dr. Michael DeBakey, a world-famed vascular surgeon at Houston’s Methodist Hospital. During an extensive examination, Dr. DeBakey placed a stethoscope on the right side of Key’s neck, heard a telltale sound. To confirm his suspicions, he had an opaque dye injected into Key’s bloodstream and an X ray taken; the resulting picture showed constriction from a large atheroma in the right carotid arteries that supply Key’s brain.

In the operating room, Dr. DeBakey performed a surgical procedure that he pioneered and has improved over the past ten years. He installed a temporary plastic “shunt” so that blood supply to the brain would be maintained during the operation, removed large gobs of fatty material from the carotids, enlarged both the common and internal carotid arteries still further by suturing a Dacron patch in their walls. Then a week later he removed the atheromas that were causing the sharp pain in Key’s legs.

Key recovered rapidly. Seven weeks after surgery, he was running up and down four flights of stairs, testing his legs on lengthy hikes. Dr. DeBakey’s operation, which has the tongue-defying name of thrombo-endarterectomy, is performed in scores of U.S. hospitals. He estimates that its use has value in some 40% of stroke cases, either in preventing the first, as in Key’s case, or the second.

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